thoracic aneurysm

[yapado]

hello
i am 28 195cm (6"5) 98kg
my mother died of aorta dissecans aged 57
her grandfather also died of sudden heart death
her sisther had a persisting foramen ovale which was discovered
an operated at the age of 40 , she also has an thoracic aortic aneurysm

i was examined in innsbruck
they are not yet sure wheter i have marfan
however i have an thoracic aneurysm at the beginning of the aorta
sized 4cm

my question
1) whats the normal size considering my age weight hight?
2) what do you suggest as a treatment
3)can i still go to the gym
4) what about beta blocker medication ? considering my blood pressure is 125/70
5)i feel pain chest since 2 years (retrosternal mild pain
getting worse when exercising..but not frightening(don't think its angina pectoris).doctors told me it has nothing to do with my aneurysm is that right ?


thank you very much

philippe

[CCF-M.D.-KE]

Dear Yapado,

I am sorry to hear about your family's history of heart disease. A thoracic aortic aneurysm is an abnormal dilation of the thoracic aorta. The normal aorta is approximately 2.5 to 3cm in diameter, you describe a thoracic aneurysm of  4cm in diameter. Currently, surgery is recommended if the aneurysm(thoracic) is greater than 6cm in diameter. In people diagnosed with Marfan's syndrome surgery is recommended when the aneurysm(thoracic) reaches 5cm in diameter. Treatment with a beta blocker is a reasonable approach at this time as long as you are able to tolerate the dose. It sounds as if you could have an inherited collagen vascular disease. I would suggest visiting a large university based medical center where there are specialists familiar with this type of disorder. The Cleveland Clinic Foundation is a leader in the treatment of diseases involving the aorta. If possibly consider scheduling an appointment by calling 1-800-CCF-CARE or visiting the website at www.ccf.org.

The aneurysm you describe could  possibly result in  chest discomfort. However, I think it is unlikely that you  have blockages in the heart arteries given your age.
This is a very serious condition which will require some form of imaging modality (CT or MRI) every 3 to 6 months or if there is a change in your symptoms. If you are unable to visit the Cleveland Clinic please visit a large university based center near your home. You should avoid competative sports and isometric exercises such as weight lifting. Mild  isotonic exerice such as brisk walking should be fine. I would also recommend discussing your concerns with a doctor very familiar with your case and arriving at a reasonable exercise plan. Keep us posted.


Thanks for your question,

CCF-ME-KE

[eileneee]

i noticed you asked detailed questions on this post and on a previous post.  i just want to let you know that the dr. will not answer questions attached to another post like this.  this forum takes two questions a day and it is very hard sometimes to be the lucky one to post a question.  someone else might read your comments and maybe give you some information which might be helpful.  some people say to try around 8 or 9 a.m. to post a question.  good luck
eilene

[cindyred]

Dear Dr,

I am a 45 year Old Woman,
5*6
139
Who has always been in great shape?
Last summer I was working out at the gym, (at the end of may work out) I began to get very severe and fast heart palpations, It came on with a (one thud) and then it just raced up to 199. I became very breathless unable to breathe or slow my heat rate down.

At the time I thought I was having a Panic Attack , But this continued to happen each time I worked out ,  I will be walking slow on the treadmill  ( 3.3) for about 30 Min and if I bump it up a bit It happens again.

I have become extremely anxious now because of this.

I finally went to a cardio Man (a great guy) he did really not believe me at first and did a stress test, on the stress test it happened. I have all the x-rays done and an echo.

He said my heart was fine, but I was having arrhythmias due to a short circuit in the natural pacemaker of the heart,
And put me on a aspirin a day and toprol-xl 12.mg at night, due to the fact that I was born with hypothyroidism my blood pressure is very low and he did not want to lower it to much,

My questions are:

1) If I have such low blood pressure in the first place , why and I having arrhythmias
2) I asked him if this was Panic Attacks and he said no,
3) If it is Panic can you tell the difference on the reading of the EKG on the stress test, does it show something else if its panic?
4) It seems to be happening more , but not as strong just ore frequent ,
5) I am not a pill person and leery of taking beta Blockers and medication if I really do not have to , I just want to understand better what this is > Why Is happens and How to at least control it ,
6) I really love to work out and would like to resume exercise but I am unsure if it will keep happening that the gym

[cindyred]

Thank you so much Elaine ,

I was not able to post a question , so I tried here ,

Thank you

Cindyred